不孕不育患者子宫内膜监测中阴道B超的应用研究

Study on the Application of Vaginal Ultrasound in Monitoring the Endometrium of Infertile Patients

摘要: 目的：评价经阴道B型超声检查在不孕不育患者子宫内膜监测中的临床价值。方法：选取2019年3月至2020年2月间本院收治200名不孕不育患者，纳入患者在接受宫腔镜检查同时进行经阴道B型超声检查，以病理检查结果为诊断金标准，评价经阴道B型超声检查结果。结果：200例患者经阴道超声检查发现子宫内膜异常率82.00% (164/200)，异常回声类型包括混合性回声67例、回声不均匀32例、回声极不均匀18例、内膜线中断18例、局部强回声光团17例、内膜线不光滑6例、内膜中线回声增强6例；包括形态正常36例；经阴道超声检查提示子宫内膜混合性回声、回声不均匀、回声极不均匀、内膜线中断、局部强回声光团、内膜线不光滑、内膜中线回声增强的符合率均 > 90.0%。结论：经阴道B型超声检查在不孕不育患者子宫内膜监测中具有较高的诊断率，该检查方法便捷、无创，可作为拟接受IVF-ET患者在治疗前子宫内膜病变初步筛查的手段，针对IVF种植失败患者仍有必要接受宫腔镜检查诊断。

Abstract: Objective: To evaluate the clinical value of transvaginal B-mode ultrasound in monitoring the endometrium of infertile patients. Methods: Select 200 infertility patients admitted to our hospital from March 2019 to February 2020. The patients were included in the hysteroscopy and transvaginal B-mode ultrasound examination. The pathological examination results were used as the diagnostic gold standard. Evaluate the results of transvaginal B-mode ultrasonography. Results: The abnormal rate of the endometrium in 200 patients was 82.00% (164/200). The abnormal echo types included 67 cases of mixed echo, 32 cases of uneven echo, 18 cases of extremely uneven echo, and interruption of endometrial line 18 cases, 17 cases of local hyperechoic light clusters, 6 cases of endometrial line not smooth, 6 cases of endometrial midline echo enhancement; including 36 cases of normal morphology; transvaginal ultrasound examination revealed mixed echo of the endometrium, uneven echo, the echo is extremely uneven, the inner membrane line is interrupted, the local strong echo light group, the inner membrane line is not smooth, and the coincidence rate of the inner membrane midline echo enhancement is > 90.0%. Conclusion: Transvaginal B-mode ultrasound has a high diagnostic rate in endometrial monitoring of infertility patients. This examination method is convenient and non-invasive, and can be used as a preliminary screening for endometrial lesions in patients who intend to receive IVF-ET before treatment. It is still necessary for patients with failed IVF implantation to undergo hysteroscopy diagnosis.